Why you should not go to medical school — a gleefully biased rant

In the few years since I’ve graduated from medical school, there has been enough time to go back to medical practice in some form, but I haven’t and don’t intend to, so quit yer askin’ already.  But of course, people keep on asking.  Their comments range from the curious — “Why don’t you practice?” — to the idealistic — “But medicine is such a wonderful profession!” — to the almost hostile — “Don’t you like helping people, you heartless ogre you?”

Since it’s certain that folks will continue to pose me this question for the rest of my natural existence, I figured that instead of launching into my 15-minute polemic on the State of Medicine each time and interrupting the flow of my Hefeweizen on a fine Friday eve, I could just write it up and give them the URL.  So that’s what I did.

Now, unfettered by my prior obligations as an unbiased pre-med advisor, here are the myriad reasons why you should not enter the medical profession and the one (count ’em — one) reason you should.  I have assiduously gone through these arguments and expunged any hint of evenhandedness, saving time for all of you who are hunting for balance.  And here are the reasons:

1) You will lose all the friends you had before medicine.
You think I’m kidding here.  No, I’m not: I mean it in the most literal sense possible. I had a friend in UCLA Med School who lived 12min away, and I saw her once — in three years (UPDATE: twice in 4 years). I saw her more often when she lived in Boston and I was in LA, no foolin’.

Here’s the deal: you’ll be so caught up with taking classes, studying for exams, doing ward rotations, taking care of too many patients as a resident, trying to squeeze in a meal or an extra hour of sleep, that your entire life pre-medicine will be relegated to some nether, dust-gathering corner of your mind.  Docs and med students don’t make it to their college reunions because who can take a whole weekend off?  Unthinkable.

And so those old friends will simply drift away because of said temporal and physical restrictions, to be replaced by your medical compadres, whom you have no choice but to see every day.  Which brings us to…

2) You will have difficulty sustaining a relationship and will probably break up with or divorce your current significant other during training.

For the same reasons enumerated above, you just won’t have time for quality time, kid.  Any time you do have will be spent catching up on that microbiology lecture, cramming for the Boards, getting some sleep after overnight call and just doing the basic housekeeping of keeping a Homo medicus upright and functioning.  When it’s a choice between having a meal or getting some sleep after being up for 36 hrs vs. spending quality time with your sig-o, which one wins, buddy?  I know he/she’s great and all, but a relationship is a luxury that your pared-down, elemental, bottom-of-the-Maslow-pyramid existence won’t be able to afford.  Unless you’ve found some total saint who’s willing to care for your burned-out carapace every day for 6-8 years without complaint or expectation of immediate reward (and yes, these people do exist, and yes, they will feel massively entitled after the 8 years because of the enormous sacrifice they’ve put in, etc etc).

3) You will spend the best years of your life as a sleep-deprived, underpaid slave.
I will state here without proof that the years between 22 and 35, being a time of good health, taut skin, generally idealistic worldview, firm buttocks, trim physique, ability to legally acquire intoxicating substances, having the income to acquire such substances, high liver capacity for processing said substances, and optimal sexual function, are the Best Years of Your Life.  And if you enter the medical profession during this golden interval, you will run around like a headless chicken trying to appease various superiors in the guise of professor, intern, resident, chief resident, attending, and department head, depending on your phase of devolution — all the while skipping sleep every fourth day or so and getting paid about minimum wage ($35k-$45k/yr for 80-100 hrs/wk of work) or paying through the nose (med school costing about $40-80k/yr).  Granted, any job these days involves hierarchy and superiors, but none of them keep you in such penury for so long. Speaking of penury…

4) You will get yourself a job of dubious remuneration.
For the amount of training you put in and the amount of blood, sweat and tears medicine extracts from you (I’m not being metaphorical here), you should be getting paid an absurd amount of money as soon as you finish residency.  And by “absurd”, I mean “at least a third of what a soulless investment banker makes, who saves no lives, produces nothing of social worth, and is basically a federally-subsidized gambler” (but that’s a whole different rant, ahem).

I mean, you’re in your mid-thirties. You put in 4 years of med school, and at least 4 years of residency (up to 8 if you’re a surgeon). You even did a fellowship and got paid a pittance while doing that.  And for all the good you’re doing humanity — you are healing people, for godssakes — you should get paid more than some spreadsheet jockey shifting around numbers, some lawyer defending tobacco companies or some consultant maximizing a client’s shareholder value, whatever the hell that means.

Right?  Wrong. For the same time spent out of college, your I-banking, lawyering and consulting buddies are making 2-5 times as much as you are.  At my tenth college reunion, friends who had gone into finance were near retirement and talking about their 10-acre parcel in Aspen, while 80% of my doctor classmates were still in residency, with an average debt of $100,000 and a salary of $40,000.

5) You will have a job of exceptionally high liability exposure.

But wait, it gets better.  Who amongst these professionals has to insure himself against the potential wrath of his own clients?  The investment banker’s not playing with his own money.  And even if he screws up to the tune of, oh, hundreds of billions of dollars, Uncle Sam’s there to bail him out (see: World History, 2008-2009).

The lawyers?  They’re doing the suing, not being sued.  But the doctors?  Ah.  Average annual liability premiums these days are around $30,000.  That goes up to $80,000 for an obstetrician-gynecologist (who remains liable for any baby s/he delivers until said infant turns 18) and into the six-digit realm for neurosurgeons.   Atul Gawande wrote a dynamite article about docs’ compensation in the 4 May 2005 issue of The New Yorker entitled Piecework — check it out.

6) You will endanger your health and long-term well-being.
The medical profession is bad for you.  Just ask any current doctor or med student.  You will eat irregularly, eat poorly when you do get the irregular meal (and sayonara to the now-outlawed drug-company sponsored meals — god bless their generous hearts and bottomless pockets), have way too much cortisol circulating in your system from all the stress you experience, have a compromised immune system because of all the cortisol in your blood, get sick more often because of the compromised immune system (and the perpetual exposure to disease — it’s a hospital where everybody’s sick, duh), and be perennially sleep-deprived.  If your residency is four years long, on average you will spend one of those years without any sleep.  A whole year of no sleep. Do you get that?  This is as bad for you as it is for patients — you’ve heard of Libby’s Law, right? Groggy doctors can kill patients when they don’t mean to.

Groggy docs can also hurt themselves.  One friend stuck herself with a needle as she was drawing blood from an HIV patient.  She’s fine now, but that was a good 9 months of panic (PS: she has since quit clinical medicine).  My good friend and college classmate James — a serious contender for the title of Nicest Guy on Earth — had a severe car accident one morning on the way to the hospital because he fell asleep behind the wheel.  Luckily, his airbag deployed and he didn’t suffer long-term injuries.  Everyone seems to know already that medical care can kill patients (haven’t read The House of God by Samuel Shem yet?  Go get it now — brilliant and the second funniest book I’ve ever read, after Catch-22), but it’s usually news that it can kill the docs, too.

7) You will not have time to care for patients as well as you want to.
This is how the math works: Many patients, few of you — usually one, unless your name is United States of Tara (and no, multiple-personality disorder ain’t the same as schizophrenia — I learned something from med school).  So you have to take care of many patients.  And if they’re in the hospital, that means they’re really sick, otherwise they’d still be at home.

So you are scurrying around trying to take care of all of them at once, which means that each individual patient can only get a little bit of your time.  Which means that you won’t have a chance to sit at the bedside of that sweet old vet and hear his stories of Iwo Jima.  Or get to the bottom of why that LOL (little old lady — medical slang’s been around way longer than internet slang, buddy) can’t get her daughter to come visit.  Or to do any of that idealistic stuff that you cooked up in your adolescent brain about really connecting with patients.

Get a grip!  This is about action, about taking care of business, about getting shit done, about making that note look sharp because the attending is coming to round in an hour and he’s a hardass, and that’s the difference between getting recommended for honors and just passing, which is the difference between scoring the residency at MGH and the one at East Bumblefuck City Hospital, so get on it already and quit yakking with the gomer (which is an older patient with so many problems you should have never let him/her get admitted in the first place — stands for get out of my ER, and I didn’t make it up the acronym, so kindly direct your righteously indignant wrath elsewhere). It’s about CYA — cover your ass.  For better or for worse, you just start to treat patients as problems and illness-bearing entities for the sake of mental efficiency (“55yo WM s/p rad prostatectomy c hx CHF & COPD”), which does not do much for your empathetic abilities.  Which brings us to…

8) You will start to dislike patients — and by extension, people in general.
Okay, so now you’re overworked, underpaid, underfed, under-laid and underslept.  Whose fault is that?  Well, it’s not really the hospital’s fault — it’s just drawn that way.  And it’s not your boss’s fault, because somebody has to take care of patients, and he can’t do it because he’s the boss, duh.

So whom to blame?  Ah yes — patients.  It’s the patients’ fault!  They’re the ones creating all the work! The ones who get in the way of your nap, your catching your favorite TV show, having an uninterrupted meal, getting together with your sig-o for some therapeutic nookie.  How dare the gomer in 345E have an MI while you’re watching CSI?  Does she have any consideration, letting her blood pressure tank to 40 over palp at 3.30am, while you’re making out with Elle MacPherson on the shores of Bora Bora (assuming you’re lucky enough to actually sleep)?  The logic may be twisted — patients, on the whole, don’t get sick voluntarily just to spite you — but it is deeply ingrained in medical culture.  Heck, there’s even a slang term for it: a hit.  As in, “We got four hits on our admitting shift at the ER today.”  Hit — the same way you would be struck by a mortar, bullet, shell, or bomb.  Getting hit is a Bad Thing.

Patients aren’t people, you see — they are potentially lethal disasters that can explode all over the place and ruin your whole day. “We got hit again” — one more patient to take care of, says the resident.

But really, is that resident blameless?  Or how about Dr Hardass the attending and his intransigent ways?  Hell, they’re at fault, too!

Soon the circle of blame expands to the outer reaches of the cosmos, and every potentially accountable organism from amoeba to blue whale will be personally responsible for your misery.  But lest you think we’ve forgotten you, patients, remember — it’s all still your fault.

9) People who do not even know you will start to dislike you.
Once upon a day, in a time somewhere between the Cretaceous and Triassic eras, physicians were held in awe and respect by the general public.  Their seeming omniscience was revered, and TV shows like Marcus Welby MD glorified their competent sangfroid and high-minded grace.  Heck, they were even considered sexy or something.

I only noticed in recent years that this ain’t the case no more, and doctors rank on the contempt scale somewhere above meter maids and at or below divorce lawyers (but still much higher than I-bankers and other invertebrates).  The average Joe and Janet are tired of the ever-rising cost of medical care, tired of all the stories of malpractice, tired of the perceived greed of the pharmaceutical firms, tired of the heartless profit-focussed practices of insurance companies.

But where do they pin their frustration?  To whom can they direct their ire?  Insurance and drug companies are nameless, faceless entities, as are hospitals.  We need a person to blame, like a nurse or a doc.  Nurses are overworked and massively underpaid, so it doesn’t really make sense to get mad at them.  But doctors — those darn Mercedes-driving, Armani-wearing, private-school using, golf-playing arriviste docs!  By being the most visible symbol of the medical profession, the doctor will have the dubious distinction of being the scapegoat for all its maladies.  Fair?  Hell no — we already told you docs are overworked, underpaid, and often railing at the same injustices Joe and Janet are.  Most of them don’t even play golf!  (They don’t have time.  Except for dermatologists and radiologists).  But such it is.  Hey, I’m just letting you know which direction the rotten tomatoes are flying so you can consciously choose to stand at the ‘toss’ or ‘splat’ end of the trajectory.

10) You’re not helping people nearly as much as you think.

So by now I may have managed to inspire your righteous indignation with some of the things I’ve said about the medical profession.  But maybe in the back of your head, you were still thinking, “Well, even though it sounds like a bunch of bitter black bile, he does kinda sorta have a point.”  In which case, I’ve almost certainly lost you on this one: “Whaddya mean you’re not helping people?  Isn’t that what medicine is all about?”

Well, actually, yes and no.  Sure, there is the immediate gratification of delivering a baby, fixing someone’s eyesight with LASIK, catching a melanoma before it causes trouble, or prescribing some thermonuclear antibiotics to kick a pesky bronchitis before it becomes lethal pneumonia.

But, depending on the field you choose, most of the time you’re not doing that.  You’re treating chronic conditions that are self-inflicted: emphysema, obesity, cardiovascular disease, diabetes.  Moreover, patients tend to be non-compliant — they basically don’t do what you tell ’em to do. In fact, you too are probably one of those non-compliant patients who doesn’t exercise more, eat healthier, and take pills as they’re prescribed.  Anecdotally, 50%+ of prescribed medications are taken incorrectly or never.

So there you are, like Cuchulain the legendary Celtic warrior, wading into the ocean and, in your rage, trying to fight the invulnerable tide and improve the health of your patients.  You pour all your earnestness, good intentions and expertise into it, and — not a whole lot happens.  Your efforts bear no fruit.  So you suck it down and move on, sustained by the occasional kid who does get better, that eyesight that does improve, that bronchitis that doesn’t turn into pneumonia.  Win some, lose many more.


You have only ever envisioned yourself as a doctor and can only derive professional fulfillment in life by taking care of sick people.*

There’s really no other reason, and lord knows the world needs docs.  Prestige, money, job security, making mom happy, proving something, can’t think of anything else to do, better than being a lawyer, etc are all incredibly bad reasons for becoming a doc.

You should become a doc because you always wanted to work for Médecins Sans Frontières and your life will be half-lived without that.  You should become a doc because you want to be the psychiatrist who makes a breakthrough in schizophrenia treatment.  You should become a doc because you love making sick kids feel better and being the one to reassure the parents that it’ll all be OK, and nothing else in the world measures up to that.  Or as my general surgery resident put it, you should become a doc because “my dad was an ass surgeon, my big brother’s an ass surgeon, and by god I’m going to become an ass surgeon.”

But woe betide you if there’s anything else, anything at all, that would also give you that fulfillment.  Because pursuit of medicine would preclude chasing down that other dream and a whole lot more — a dream that could be much bigger, much more spectacular, much more enriching for yourself and humanity than being a physician.  Just ask John Keats, Walker Percy, Sir Arthur Conan Doyle, Giorgio Armani, or Michael Crichton (some of these guys being more alive than others these days).  Or you can just ask me a few years down the road, by which time I should have a blog entry for that question, too.

*Also acceptable: You want to get into academic medicine. Pretty much need an MD or MD/PhD as prerequisite.

Update 1: To those who are wondering what I’ve been up to since the writing of this article — that’s a long story. Most recently, I’ve been writing books, including the #1 rated dating book on Amazon, The Tao of Dating: The Smart Woman’s Guide to Being Absolutely Irresistible. Check out also the very popular dating ebook for men and my other blog for more articles, as well as my HuffPost archive.

Update 2: As of 9/24/2011, there’s a Hacker News thread on this piece, with hundreds of intelligent comments from people with firsthand experience about the medical lifestyle. Check it out.

Update 3: In September 2012, a survey by The Physicians Foundation found that 6 out of 10 physicians would quit today if they could. Click on link to find what’s driving the trend.

Update 4:  In Oct 2012, Jake Seliger of the excellent blog The Story’s Story wrote a magisterial article on why becoming a doctor is a bad idea, with many angles that I hadn’t even considered. The whole antitrust suit against the Match and how it’s basically an illegal trust and how the AMA bought off Congress to head off lawsuits was particularly sobering.

Update 5: I recently had the opportunity to speak to the daughter of the lady who was the dean of of my med school. She told me that her mom specifically forbid her from going into medicine. Did you get that? THE DEAN OF MY MED SCHOOL FORBID HER DAUGHTER FROM GOING TO MED SCHOOL. I don’t think there’s anything else that could validate my decision more. This means I win.

Update 6: Great article from the Wall Street Journal on 8/29/2014: “Why Doctors Are Sick of Their Profession” by Dr Sandeep Jauhar. May also want to check out his books Intern: A Doctor’s Initiation and his latest, Doctored: The Disillusionment of an American Physician, released Aug 2014.

Comment rules: There have been a lot of comments on this article over the years, so if you wish to comment, here are the rules: if you have an intelligent contribution to make, I’ll approve it. I’m not anonymous, so you shouldn’t be either. There’s no room for hate, spite or derision on this blog, so comments containing them won’t see the light of day.

447 thoughts on “Why you should not go to medical school — a gleefully biased rant

  1. Lauren

    This article is very well written and gives many fellow pre-meds a lot to think about. Things they should think long and hard about before they decide to enter medical school.

    I would like to offer a different perspective. What about those pre-meds who have not been successful at getting into medical school and feel like their life is not complete? Those that are unchallenged and unhappy in their careers? My point being that the grass always seems greener in any situation. I am currently trying into get into medical school and have thought about this path for the past ten years. It took me a very long time to get the courage up to try and I have applied once and was only accepted abroad. I have deferred while I think about it, as I would like to get accepted in North America. I think about these things you wrote about in the article everyday. Why do I want it so badly? Why can’t I walk away? I am almost 29, and many of my medical school friends say they also wouldn’t do it again if they had the chance, but how can they really say that? I find it hard to believe when they are finished residency that they will really think that. I agree the training is horrible, and I am sure if I do it, I will ask myself a million times why I am doing it. But I strongly believe there is something that draws many medical students to medicine. I believe it is a calling. Maybe I am naive.

    Also, I am so sick of hearing that medical school is expensive. Firstly, that is not a secret and anyone who hadn’t looked into it before was not being responsible. Secondly, how is it more expensive than any other American program? Undergrad degrees are also expensive and many don’t lead to a job. My cousin’s in law school have the same amount of loans, and many students in their classes don’t even have jobs when they graduate. At least with a residency, you are getting a bit of money versus being unemployed. Every degree in America is expensive, and medicine is no different. The difference is that doctors DO get paid, and get paid quite a lot. But also, those that complain that it was expensive have maybe gone into it for the wrong reasons.

    All I can say, is while the author spends time complaining about being a doctor, every year thousands of applicants are upset because of their med school rejection(s). They want this more than anything, and I really believe that a positive attitude is essential in life. The grass always seems greener in any situation you look at.

    I am trying strongly to consider being an NP or PA, but a small voice keeps saying why would you not be a doctor? That’s what you have always wanted. I will try to remember these points if I decide to go into one of those professions.

  2. MK

    This original post is pretty much spot on. I have been out of residency for 5 years as an OB/GYN and am 35 years old. I want out. Problem is that I am not really qualified for any other job, definitely not a job that would be enough of a salary to pay off my 200,000 in loans. So like many of the other posters, I am basically stuck, at least until I can pay off the loans. Jobs advertise that call every 5th night offers a “great lifestyle”. What planet are these people living on? Delivering babies is fun during medical school and residency but do you really want to be up at 3am doing that for the next 30 years? Then after you are up all night you get to go back to the office and see patients all day long. Then you have to worry about the malpractice on top of it. And frankly , as the initial post mentioned you really just start to dislike the patients since they are the barrier between you and going the hell home. I was a totally different person when I applied to medical school, I went back and read my personal statement and I literally don’t remember that person. You start as a optimistic person who is going to help patients and you come out at the other end a heartless injured person after your soul is sucked out from the training and the system.

  3. peds dr

    Here’s my biased rant indeed: I see no harm in this article. If someone is easily dissuaded from a blog article in which the author admittedly never practiced medicine and claims to know what it’s like to be a doctor, then by all means they have no business being a doctor. There are the casualties of war in medicine for sure. Doctors who by sheer misfortune have a crap career. Doctors who mismanage their practices because of arrogance (think they are so smart that they know how to run a business with no business experience). Doctors who (when naive young undergrads) have all the WRONG reasons for entering the medical profession, such as: daddy/mommy, money, prestige, etc. Some people are just bitter, and will always have a negative outlook on life no matter what profession they are in. All polls and surveys are biased in some sense, especially who actually responds to them.

    I HATE statistics that ask “if you had to do it again, would you?” It’s a question for romantics and daydreamers. In reality, look where your feet are. If your head is somewhere else, of course you hate the present, you can’t look around and enjoy it at all. You are always wanting something else out of life.

    I was a 10 year military veteran before entering medical school, seeing deployments, hardships, and worse working hours than ANY medical resident (except maybe neurosurgeons, they are crazy, lol). Medical school wasn’t easy, especially the first two years. I had been out of the studying game for a while. The hardest part of the clinical years was dealing with residents or young attendings who had never experienced: the real world, a decent salary, leadership, etc. I had to bite my tongue quite a bit, and when I didn’t, my grade took a nice hit.

    So I graduated and entered pediatrics. Quite a change from my prior military life indeed! Not a SINGLE person every told me residency would be easy. If you want to do something easy, DON’T be a doctor. Go do something else, anything else.

    I see doctors who hate people. I equally see a deeper seeded self-loathing and poor insight in general in those same doctors. I see doctors who sacrifice their health along the way, because they choose to. They choose to eat the crap hospital cafeteria food instead of the healthier options or pack a lunch. They choose to stop exercising. They choose to abandon all personal interests that contribute to their livelihood. They choose to keep making excuses how the medical world is against them, and they are just a victim.

    I’m close to 40. I eat healthy, have a wonderful son, great friends, am in outstanding physical shape, volunteer, surf, read, study, coach, and whatever the hell I want. The best part is, I get to do what I love everyday AND get paid for it.

    It should come as NO shock that medical school is expensive. Luckily for me, I had the GI Bill to help pave my way through. The only reason I continued my application process is because I had reasonable expectations of being able to minimize my debt and was granted an opportunity to afford medical school through a decade of military service. To the young and naive: Going into debt at all costs for a dream is a huge price to pay, and you better be ready to pay it. You should accept that you dreamed of becoming a doctor, not becoming rich.

    In the end, this is a great article for stimulation. I’ve been at this game for a long time, and it keeps getting better. It’s a matter of perspective. If you are fed up with medical school, medicine or whatever, then change your perspective because the world isn’t going to change no matter where you go, what you do, or who you know.

  4. Dr. B

    I quit residency at senior level last year and very happy with my decision. The premed and med students whom we babysit everyday have no idea about real life. I fully agree with every single sentences in this article. Every doctor I met in my 15 years of medical career told me that they would not become a surgeon/doctor if they could go back in time.

    It is a job, just a well paid job. as they said, only %1 of people can make this amount of money. But they all missed the point; less than %1 of people would like to work so hard, invest so much (time, money, etc) on a fucking job.

    Here is the best part!

    You have only ever envisioned yourself as a doctor and can only derive professional fulfillment in life by taking care of sick people.*

    There’s really no other reason, and lord knows the world needs docs. Prestige, money, job security, making mom happy, proving something, can’t think of anything else to do, better than being a lawyer, etc are all incredibly bad reasons for becoming a doc.”

  5. medicare connecticut

    Its interesting to note in this article about doctors eating poorly and irregularly and yet preaching to their patients about the importance of good diet and exercise. So funny and ironic at the same time. Of Course the amount of hours and liability alone make it seem also not worthwhile. Unfortunately its only going to get worse.

  6. Dr. No

    I have been sarcastic. Can you tell that I am “Dr. No”? Doctor, hell no.

  7. matt

    med school is rough, but if you have a clear goal in mind it can be well worth it.

  8. Marie

    I was single, poor, with no health insurance, and unhappy before I became a doctor.
    I’m single, poor, no health insurance and unhappy after becoming a doctor but now I’m $160,00 in debt and last loan payment is when I’m 65.
    Your better off showing your &@#$^ on the internet. People actual respect you more than if you were a doctor.

  9. Dr. No

    Don’t believe what other people tell you. Just go to pre-med and become a doctor. We need as many as the country can take.
    After all, who is going to take care of patients if practicing doctors are quitting and less qualified youths are getting into medicine?
    Misery being a doctor? Haha.., never heard!!

    Dr. No

  10. Sam

    I read this article in undergrad and it scared the crap out of me. Despite this, I still applied to medical school, got in, and am almost done with my first year. I was terrified of starting medical school because of pessimistic articles like this but do you know what? I love what I do every single day. This last year has been the happiest year of my life. I get to wake up every morning with the knowledge that I am living my dream, how many people can say that? Some people don’t go into medicine for the right reasons and thus resent it, don’t let those people scare you. I have plenty of time to eat right, exercise, get a good nights sleep, keep in touch with old-friends, and maintain a long-distance relationship with my significant other (we still manage to see each other every weekend). I’m not sure anyone will read this, but I wanted to give another perspective to the scared pre-meds who read this article.

    Dear Sam: Right now, you are 100% unqualified to say anything about what it’s like being a doctor. The pre-clinical first two years of med school, like everyone knows, is merely a continuation of college. Country club, basically. Lemme know how you fare once you hit 3rd year and lose two nights of sleep every week. — Dr Ali

  11. Robert

    I told myself I went to medical school because I enjoyed a challenge, but as I reflect upon my choice, I recognize now that I was driven by insecurity. Not only would I seek a career in medicine, but I would become an orthopedic surgeon. The first dirty secret of medicine is that in order to perform effectively, one must initially go through a process of desensitization, or what might more accurately be described as “dehumanization.” Starting as one who was by nature repulsed by cadaveric dissection, and who was so innately disinclined to perform venipuncture upon a classmate, not for fear of blood, but because the thought of inflicting pain was so abhorrent that my hand would shake; it was a remarkable transformation that I would become one who could without hesitation bring a scalpel through live flesh to bone. The second dirty secret of medicine is we are conditioned by rite of passage through the hell called residency to believe that failure to perform is a sign of personal weakness. It could only have been my insecurity and need for affirmation that I would emerge into private practice and without second thought respond to the middle of the night emergency, labor for hours to reconstruct the self-pay (no pay) trauma victim’s open fractures, exposing myself to not only potential blood-born pathogens, but malpractice liability, and then continue to work through the next day. Yet at some point in my career, the dwindling reimbursements, the diminishing expressions of patient gratitude, the erosion of my decision-making authority by third-party payers, the constant threat of litigation; my practice was no longer providing solace to my insecurities. I could go on, but sadly I have to get back to work.

  12. Kweku Dennis

    All those looking to quit please please please do not take your debt into consideration. That is slavery

  13. Jeff S

    Then there’s this:


    And many books like it: the “literature” is packed with alternatives for docs who’d want to do something else after first-hand experiencing modern doctoring.

  14. I have read this post. The BOTTOM line here is that any and all that people do and say about your care as a physician is NOT discoverable. Those of physicians amongst us that understand what this means….get it. Those that don’t, well, there in lies the problem. There is NO level playing field and NEVER will be.

    Patients will pay $500 or more for tickets to a game and then choose health plan with LOWEST co-pay and argue it SHOULD be a good plan. Now what that same patient for $600 for cell phone. Americans don’t value their physicians.

    Good luck….

  15. Bumpy


    Thank you so much for this blog post and the accompanying comments. I’ve pored over them numerous times as I am a non-traditional student that is trying to get into medical school (nearing the end of the pre-requisite class phase).

    While I’ve always considered medicine as a potential career, to be honest I’ve always seen it as something that could provide a stable lifestyle in times of economic uncertainty. The potential for it to be interesting never really stemmed from me having a passionate interest in studying disease pathology but more from the potential for it to be unique in its ability to spend one’s life interacting with a broad cross section of the human spectrum on a daily basis. So I’ve always been more interested in medicine from the sociological perspective.

    I shadowed a physician in Orthopedics a while ago, and it was a crushingly disappointing experience. Although he did see a wide variety of patients, there was a rote, monotonous, mechanical nature to his interactions with every patient. It was having the same conversation with 25 people every single day. So not only was his schedule incredibly rushed, it was incredibly repetitive. I never knew being busy could be so boring.

    My question is….is this typical for many physicians?

    Also, the past two years have been deeply unhappy. I have not enjoyed any of my prerequisite classes (but who does?), and I’m intrinsically a more social sciences oriented person. Is that a terrible sign? I don’t know…I mean as much as doctors seem to express disappointment about their careers, a lot of people still seem to go into it, hence the hyper-competitive nature of the whole process…so it can’t be that terrible?

  16. Zulvina Faozanudin

    can I share this writing to my social media account? it’s somehow interesting…

  17. Sidra

    I remember reading this article when I was in college! I had it bookmarked. I was a premed, but also wanted to settle down and have a family. I read many articles about how medical school sucks, trying to dissuade myself from medicine. The argument here that one would spend age 22 to 35 (‘prime’ years) was particularly compelling for me. After I graduated with my degree in chemistry, I obtained my substitute teaching certification and tried to search for a teaching position. I figured it would be more family-friendly and also I could do stuff like travel and enjoy myself during summers.

    I did find interim teaching positions, but nothing long-term. When I read this, I had that flash of recognizance. I saw it was published in 2005. It means I read this when I was 20. I am now 30, turning 31 in 10 days. I did not get married or have kids in the last decade. I do agree that medicine does suck out a lot of time and energy. However, if you are going to be old and single anyway, it is better to be old and doing what you want.

    I spent my 20s in an illusory fog, believing that I would make lifelong friends, get married, have kids, go on adventures, and not be a slave. But, really, when you don’t have money, you can’t enjoy life anyway. I could have chosen some alternate career paths, of course. Life doesn’t have to be either be a underemployed loser or a doctor. But my point is that if you do like medicine, all these negatives are really NOT THAT BAD. I think the biggest problem is many people get into medicine from external pressure, or they just rush through high school-undergrad-med school without any break to experience the outside world. I would encourage students to work during undergrad and take a break after university. Experience brings perspective that can help a person make a better choice. I just want to say, don’t give up on a dream because you fear you will miss on life. I didn’t enjoy life really, and I lost my dream too. In four years, I’ll be 35. I feel as a doctor, even if I was single and unmarried, I would feel somewhat useful to the world. I am just including my story so readers can see an alternate viewpoint as well.

  18. Michael V. MD

    I love my job. It’s scaled down from the ER days to an Urgent Care, but I didn’t leave the ED because of the miscreant patients, lousy hours, or insurance hassles. I left because I had to deal with my colleagues like this author. I got tired of having to be the only one who felt duty bound and compelled to work odd hours, weekends, holidays. News flash–It goes with the profession of service. I can perform the roles of many physicians but I couldn’t and can’t be them all. I don’t do surgical orthopedics or neurosurgery or invasive general surgery. I can’t attend ICU patients and run an ER simultaneously. I really don’t want to reinvent the wheel and learn the complete ins and outs of chronically ill patients and manage their inpatient care when their MD has these insights already. All this “Go to the ER”, when they don’t feel like making the effort–not because they needed the greater level of care.

    Bottom line, I got tired of all colleagues belly aching about actually having to WORK. Contrary to the rallying cry, none of us are starving or paupers…unless you don’t want to work or manage your money correctly or (horrors) live within your means.

    Plenty of people work harder than us for a lot less. Many have sacrificed not just their youths like us, but their entire lives to make ends meet.

    Alot of this discontent comes from generally discontented people, the grass will always be greener doing or being some place else. So many of my peers say they HATED the first 2 years of medical school. I thought they were the best years of my life. Made some life-long friends, one of whom genuinely and literally saved my life once. When we wanted to take a weekend, we agreed to bust our cans and live in the library to get all the studying we needed to get done ahead of time. We had a life outside the course of study–we made it happen. We just chose not to enslave ourselves.

    I can take the abuse of society, insurers, government entities–to some degree that has always been there. But the abuse that comes from my less than committed peers is what is truly disheartening. They want the money, but they don’t want to absorb themselves into calling like our forebears did. I grew up in a medical household, and my Dad and all his friends worked ungodly hours, but they were in it together whatever their specialties. They socialized and partied and vacationed together. That just doesn’t happen as a rule anymore. The collegiality amongst us has eroded to nearly “every man for himself”.

    BTW, I’m 53 and finished medical school 28 years ago. Plenty of time to get jaded against the medical profession and system. I find myself only getting jaded against medical professionals.

  19. To any bright, dedicated young person reading this: Please please please DONT STUDY MEDICINE.

    There are 4750+ Australian GPs who are identically trained to the majority of their peers. These 4750+ GPs (Primary care doctors) are paid only HALF Medicare from the Australian federal government for the exact same work and responsibility. They are on a pittance.

    All Western governments, bureaucrats and media, have it in for the medical profession. This will only increase as the population ages, health budgets strain and medical care continues to consolidate under the banner of corporate conglomerates: in turn this will erode professional independence and standards.

    Please do yourself a favour. Save yourself some of your LIFE. Save yourself from grief. Study something else.

  20. Rufus Herring

    Dear Ali,

    Thanks for a very useful blog. I left medicine after 14 years of practice and it is one of the best decisions I have ever made. Having spoken to many people, it is obvious that a huge variety of opinions on the matter exist and there is no broad consensus or feeling on how good or bad medicine is in general. I have heard in person and seen on the interwebwork the often strongly worded, and sometimes even bigoted things people write many would vigorously defend how good it is as a career. I have several, hopefully, well balanced things I’d like to add. Mainly, I’d like to emphasise that choosing to study medicine is a huge and ultimately fairly unwise risk.

    1. It is not for everyone; it is impossible to characterise any single type of person who likes medicine but often they are fanatics, quite happy to forgo a normal life for one reason or another. Many happy doctors are not normal people.

    2. Some who say it is good genuinely love it, but many who say so are merely voicing a defence mechanism they use to cope with the difficult life decision of deciding to live with a career they secretly hate, ie. they are lying to themselves and everybody else around them in order to mainupulate themselves into facilitating the hard decision to stay in medicine over the arguably equally hard decision that leaving would entail.

    3. The lives of so many doctors are so taken over by their work that they eventually lose sight of what a normal life is and how much better life could be outside medicine. They think they have it good.

    4. The people prospective med students are at the age of 16-18 when they decide, by their subject choices in school to commit to a medical career are in many ways very different to the people they will become after finishing medical school at 24 and then again when finishing a residency and all the crap that comes with it at maybe 35. They are a lot less life experienced, with different needs and mentality and in many ways different people. Many will not regret their decision, but many do and the rub is that it is impossible to know unless you have been there in a career level job. For those who discover at this late stage in their lives that is was all a bad mistake, you have a stark and horrid choice, choose to be stuck in a career you hate for the next 25-30 years, yearning for retirement from age 35 onwards or choose to accept that you have wasted vast amounts of money and the best years of your life to learn this hard lesson and to start at the bottom rung of something else at age 35. The bottom line is that however you look at it, choosing to study medicine is a massive risk and if you like it, jackpot, if you don’t, square one again. Believe me, many doctors are stuck and counting the years. Ugh. Nobody tells you this and it is not as obvious as you think as many 18 year old wannabe doctors are idealistic, have an unwisely high ambition:realism ratio and hear nothing except how good medicine is. You have been warned.

  21. I agree with everything you stated here. The problem is that you have only displayed a minimal point of view for going into medicine.
    1. It’s one of the highest employment rates of any profession.
    There is a huge need for physicians, and employers will knock down your door to recruit you.
    2. Long hours go with many fields.
    After spending eight arduous years in the military, medical school feels like a vacation
    3. The income will more than make up for my trouble:
    After calculating all of the lost income from my service in the military, including expected promotions, and adding in debts, I’ll break even within about six years of finishing residency. At that point, I’ll have the sky as my limit.
    Your statements about lawyers and brokers is true; they make more, but your odds of getting one of the top paying CEO banker jobs is much lower than getting a good paying position as an MD. This is conjecture, but I feel like its based on experiences of life and a combined perspective from having friends that tried that route.

    I think you might be able to either beef up your argument, or perhaps add weight to the opposing view point by looking at median incomes of various graduate/professional and undergraduate degrees.

  22. Thaddeus Buttmunch, MD

    WhatEVER you DO, do NOT go to a Foreign med school like I did. The Abuse you will endure on BOTH sides of the Rio Grande-or Wherever- is NOT worth it. You are a prisoner There and Ex convict unwanted foster child in the US. You will Not be able to GET the “NPC” specialties and forced by default and proxy into the Hell of Primary Care. Brand name drugs must be prior authorized and you know WHAT? If the patient goes to CVS, Walgreen’s or a private pharmacy instead of Walmart KMart Target etc. the GENERIC will even come back as a prior auth (or the patient will spend twenty five bucks a script instead of five bucks) newsflash they will Not spend extra for anything but malt liquor cigarettes or Crack!! So YOU or your nurse will have to to the mind numbing paperwork, along with wheelchair, handicapped sticker and power wheelchair paperwork. You will not USE your Calculus Organic Chem or Anatomy skills as a practicing MD (OK some of us are Grateful we do not have to use these things-lol) you are a lifelong slave to the Bureaucrats. And NOW, even as they replace us with PAs and NPS, we ALSO have to recertify and do Stupid modules every ten years or less. That Sucks!!

  23. Jess


    I think it’s ironic and hilarious that upscale stripers can make more than doctors/same pay as sergeons. Top paid strippers at Ricks Cabaret make 600,000-800,000 per year and the IRS can’t track how much they actually make. hmmmm… I know what I’m doing after PA school!

  24. Anda

    I found it great. All of it…not only the post bit also the comments. But now…I am even more confused
    Well… while most of you are commenting from the point of view of a doc/resident/med student I am finding myself reading these comments from the point of view of a confused European student who is trying to decide what to do.
    I had many career options in my mind along the years (psychology, economics, languages etc.) but for the last 2 years of high school I’ve been sure that I will go to med school. I put some effort into it.. to find myself now ..full of doubts…in my last year of high school when I should be sending applications and personal statements and all these.
    I am not sure anymore if medicine is right for me or if I am right for medicine. To be honest, I think I’ve never been. My mom is a doctor but she also studied economics after medicine and she always worked as medical/general manager in different health care companies…so she did not get to practice much. She does not put pressure on my either and she is going to be happy whatever I choose as long as it makes me happy.
    The problem is I have been imagining myself as a doc but more for the credit and the social status that this job supposingly provides. But I can’t imagine working in a hospital for life. On the on hand this job attracts me because of the society but I must admit I find some parts of medicine very interesting I would like to be able to get to know this kind of stuff. On the other hand I love psychology but I don’t know it that is going to bring me a good salary or satisfaction. To be honest I’ve always wanted to have my own business and university was something that needed to be done in order to have a qualification. And I also want to have a life and enjoy these years not to be stressed-out all the time and I do not really like sick people…
    Now there is a battle in my head between going to med school (or at least trying as long as I’m only 18) and choosing something else..probably psychology.

    I would really appreciate some advice. Thanks !

  25. Somebody

    I recently graduated from pharmacy school from a 6 year program out of high school. I wanted to do medicine when I entered college but had doubts from what I was hearing from others in regards to medicine. I did NOT want to do medicine for the money but rather because I absolutely love anatomy, physiology and biological sciences and love the idea of lifelong learning. Anyway, I was very doubtful I’d get into medical school from the start, so I went with pharmacy school. The material was dry, but my family was convinced it would be good for me as it would be less stressful, with a good pay/stability (somebody also mentioned under the comments here that their husband does pharmacy and the benefits mentioned was what I was hearing all along). I didn’t enjoy learning about drugs/therapeutics, but stayed in pharmacy school because of the pathophysiology believing clinical pharmacy might be an option for me. 2010 pharmacy started to undergo a major saturation due to an increased # of schools leading to an increased number of graduates that exceeded the number of pharmacist jobs available. At that time, I was in my first year trying to find a pharmacy internship. Pharmacy students, majority, work internships during school whether in retail, hospital or rarely long term care, etc. to gain experience during school. Before, getting an internship was more so a preparation for the real world work but now it is an ABSOLUTE MUST if you want to work. I tried every pharmacy I could at every retail, hospital, independent pharmacy. I sent my resume everywhere. Asked my parents to forward my resume to people they knew. Nobody came up with anything. I struggled for 3 years trying to find a student internship and graduated empty-handed. So I found out the reality of working in pharmacy when i did my student rotations. One of my BEST rotations was my internal medicine one. I worked alongside doctors, rounding in the ward, attending morning/noon conferences. I was enjoying this so much while the other pharmacy intern with me absolutely hated the extra learning that the medical doctors were required to do. I learned so much more in a week than I did in my 5 years of schooling and was so eager to consider a career in medicine again.
    However, remaining realistic, I graduated and decided to work a little before jumping the gun. The issue is that without intern experience I wasn’t able to get a post-graduate residency nor a job at all, basically. In hospital, it is getting near impossible to get a job without a residency, now imagine trying without any intern experience at all. Retail is tough but doable if I move to a rural/remote location. For medical/personal reasons, I can’t do that at this time. So I’m 4 months out of school, unemployed applied to 30+ hospitals with no word and incredibly frustrated. I’m looking into government positions or health start up companies that have openings for clinical positions. This is definitely a tough job search and I am still romanticizing the thought of medical school for the near future. However, I also have generalized anxiety that I fear would make medical school an unrealistic choice for me, no matter how exciting it sounds right now. I am confused what to make of the articles and comments. I appreciate your honesty and definitely have had these sentiments from many in the medical profession. Many people who I know are doctors are indifferent or unhappy with the way medicine is going, but some of the comments above seem that some people still love what they do. I never had an avid social life, barely made any close friends in school, so that’s not really a concern. However, I do burn out and get stressed/anxious more easily than I’d like to admit. I hope I find a job first and figure out eventually if med school is for me. I’m 23 now and would probably be looking at 27-28 to enter med school.

  26. Marty Malmsteader-Stein

    You make a good case. Pharmacists are in the boat with you as well. We should all take comfort in the fact that our government has had a plan in place for a long while to keep the US supplied with the best docs. They will let anyone from anywhere take a few tests and become physicians. The general public then has to deal with the broken English and the low quality of training they bring in from other countries. It would seem that the great melting pot is laced with opium…..lol



  27. Sally

    americans villify doctors–they are hated, not appreciated. Debts are outrageous, other countries med school is completely paid by govt. In states, you get debt, stupdent loans, and ride that american hamster wheel for 20,30,40+ years for what–war dejour? Boy cott doctoring in the states. Better off being a school “teacher”–1/2 year, full pensions, full health, tenure, and 50-90K for 1/2 year of work with only a state school bachelors. MD==suckers

  28. Harry L

    This is one of the reasons for me not going through with Med School, I have family and all the docs I worked with advised me against it literally because my relationships would be strained. you definitely have to be a certain kind of person to do this, I got EE from a patient and still love the field. I am a Radiology Tech now and wanted to be a Radiologist but I am considering being a Radiologist Assistant know (mid level provider) only two more years of school and no massive debt or time killer. My dream was to be a doctor as a kid so I figure RRA is close enough. All before the age of 30. I could even use the extra time to go to law school.

  29. asf

    I dropped out of nursing school. I am so close to finish it, but I came to dislike patients, doctors,patients’ family and the hospital admins. Above all, I hated dealing with old grumpy kinky people. What’s wrong with today’s health care system?

    I am so glad that I can wake up at 8 am.

  30. neuroperson

    As someone who has practiced medicine for 20 years this article is basically all true, and the real world for medicine is even more vicious at times than the author has said. To succeed in this bizarre medical industrial complex requires real guts, adaptability and a heart of stone. Im doing quite well now.. but have lost my hair, my eyesight, and have been divorced twice. If I were to do it all again, probably dentistry or pharmacy, or to be honest..gone straight into finance and become a hedge fund manager.

    And for all you idealists, dont kid yourself, you are not really helping people often. Medicines are all poisons (pharmakos is Greek for poison), most procedures and surgeries are unnecessary, and most people come in with problems caused by their diet and lifestyle and by the time they are seeing you its already too late.

    Its all a game, but largely at your expense.

  31. Akriti

    I am Akriti. I have already written in this blog previously and I want to share something . I m in my sophomore year of biotechnology course and it happens to be really challenging and interesting ! We have couple of subjects pertaining to medicine just to get through the basics and it’s just too much to learn in just 5 months ! But , it’s interesting too ! I wonder how do med students study all this in just 2 years ! (Anatomy and physiology) Frankly speaking , all that I wana do is to serve people in whatever way I can , even by working as a scientist . Apart from this , I have always had this weird urge of learning the make up of a human body and I personally feel that whenever I happen to be jobless or just get overwhelmingly intrigued by the design of our bones and muscles and tissues and cells :p I would wana learn more and more about it and keep amusing myself by learning the wonders of our body at my own pace :D I don’t really mind not taking up mbbs and pursuing biotech as my career because be it a doctor or a scientist , at the end of the day , both are equally important to serve the people in their own way !

  32. StevenStallone

    You should have become a fireman. They make $100,000 a year and most of the time they take turns sleeping in the firehouse while one guy goes out and gets the lunchmeat.

    And they get $800 a month extra money for saying that they will become available if a big fire breaks out and they are needed and called into duty.

    Most fireman never get a DUI, because the cops drive them and their car home when they are caught drunk.

    And everywhere they go, they are a hero to everyone.

    I never saw a group of people get so much for doing so little.

  33. Steve

    Hi Ali,

    This is a great post, I know it is pretty old now but still wanted to comment. I esp agree with no.6 about your own health suffering as a result of working in the medical profession! Also due to red tape etc you often can’t help people as much as you’d like, is really a shame.

  34. Elleir Noire

    story as yours. Maybe, I have to think it over before making a huge decision in my life and career. It’s funny how I struggled to find the perfect premed course when I might end up not taking med and being a surgeon after all. I am thinking of taking Ph. D. after M.S. because my field is getting interesting and I suppose, I might live a much more desirable lifestyle.

  35. Elleir Noire

    Good day. I am currently a Nutrition major and planning to take up medicine after finishing my masters. This is an excellent article and I find it very straightforward. I once read a book titled Learning to Play God. The author, Dr. Robert Marion, had exactly the same

  36. Bethany de la Cruz

    I cant believe how long ago this was posted with all the recent comments still pouring in! A very eloquent defense of doing things for the right reasons. No matter what you choose to pursue in life it shouldn’t be such a secret that this is the only certain path to happiness.

  37. Andrea Monroe

    Wow sounds like a nightmare. I currently work in Investment Banking at JpMorgan. 23 yrs old been out of school only 2 yrs and make decent money but I really don’t like business. Was thinking about going into Medicine….but for the amount of years and investment I think I may be better off staying in finance or going to law school to be a Corp Attorney, I would spend less on my higher education as JpMorgan would pay for my MBA or JD if it relates to business and I would make a lot more and still be able to maintain a cushy corporate lifestyle without the nightmare described above. However, I commend those who put themselves through this if all that you say is true. The world does need more doctors, especially those who are in the medical field for the right reasons, to diagnose, help & care so I definitely give you a round of applause cause my job makes money but I wish it actually “helped” people or served a better purpose.

  38. Greg

    College Freshman- There’s a difference between “not knowing what else I would do” and “nothing else I’d rather do.” You can do ANYTHING. YOU can start a business and become a millionaire, travel the world and meet interesting people, become a professional athlete, etc. The only thing stopping you is yourself. If medicine is the only thing you want to do, then do it! If there’s anything else you want to do, do that first. (You can always come back to medicine)

    Colleen- You said it yourself, you’re a kid. Enjoy your youth! With that being said, try and shadow some doctors to start getting a feel for what being a doctor is like. You have a long time to decide if medicine is right for you, but don’t close any doors quite yet!

    Madeleine- The “hatred” for medical school stems from the people who probably shouldn’t have gone into medicine in the first place. That’s great you’re interested in derm- very tough to get into, but they have a great lifestyle and decent compensation. Keep in mind that some people would be unhappy in derm, just like some people would be unhappy in surgery and vice versa. There is certainly a shift occurring with all specialties towards a “I want a life outside of medicine” viewpoint. If you decide to go to medical school keep your options open- you never know what you’ll enjoy most.

  39. I.R.

    I am so sad I did not read this article 5 years ago when I decided to go into Med School without giving it much of a thought, since both my parents are doctors, and I didn’t really know what else to do. After these 5 years, I always felt like I was the ogre of my class, hating the bad aspects of being in med school, but certainly, we are on the same page.

    Actually, your article is dead on.. I laughed and also a little tear might have escaped while reading it because it is so unfortunately accurate. I also am thinking about finishing med school and not studying a specialty nor practicing, because of exactly the points you mentioned above.

    My advice to people who are NOT SURE if they should study medicine, DO NOT study medicine.
    Only do it if you are literally 100% SURE and it is your lifelong dream and really CANNOT imagine yourself NOT being a doctor.

  40. Kyle

    Madeleine – You are making a huge mistake if you are planning on going to medical school for the money or lifestyle. Specializing in dermatology is extremely hard. Yes they make a very good salary and have amazing hours. However, this is the reason that it is so competitive. You must be in the top of your med school to even have a chance to get a dermatology residency, and even then, it isn’t guaranteed. There are other specialties that are more lifestyle geared, but it seems that many med students are catching on, and these lifestyle specialties are becoming more and more competitive. If you truly love medicine and can’t see yourself doing anything else, then go to med school. If you can see yourself doing anything else, then maybe reconsider your career options.

  41. RL

    Dermatology is vey competitive and you have to be at the top of the class to be able to get a residency in it. Which would mean you would need to work extra hard during medical school, which already demands most of ones life.

  42. Madeleine

    I was just wondering if the hatred for med school and being a doctor is for all specialties, or if y’all are just talking about surgeons. I was thinking about maybe going into the medical field but specializing as a dermatologist because I’ve heard it’s a specialty where you can still have a life and a family/you won’t be called in to work at 2am type of thing. Is this true, or do you suggest avoiding medical school in all?

  43. Holly Schneider

    Thank you! For the real view of determining med school. I am an NP and love love love what I do, not the piddly pay and low status, but the ability to see, help, recommend and prescribe if necessary. I am tired of having knowledge (albeit less detailed) & experience and not having the respect of the medical community to allow my independent practice. Hell, I work completely independently now! I’m smart enough and humble enough to say “I don’t know what that is”, and apparently it’s not good enough to say “let’s find someone who does”. I was considering taking a bridge program to MD, but I think I’ll stick it out a while longer. I went to graduate nursing school because I didn’t want to be a doctor. I wanted to listen and teach and then treat if needed.
    Well, I still don’t want to be a doctor (although some days the money and status would be nice). AND I may tell my son, who has considered being a doc since kindergarten, to start with nursing first, work a little and see what happens. Thanks again, I’m glad I found your blog!

  44. lynda

    Hi everyone!

    I think that something is lacking in some physicians: they don`t believe in God. This is a big problem because if they did:
    1) They will pray and feel a happiness that definitely help to stand all the bad parts of this world and to see more clearly what’s going on, what is true and what is only an illusion.
    2) their narcissic “tendencies” will all be directed to the one and only, to God that is the Real Healer and the one that decides when we live and when we die, and if we recover or not and when. This makes the physician more humble and will decrease a lot of the pressure that is on his shoulders and allow him a better understanding of life and therefore,make him handle it more serenely. Also, this will make him understand that,he should treat his med-stududents, nurses and others that don`t have his knowledge with more tolerance because he knows that God knows better than him and God trats him well so he should do so.

    3) The trust in God makes people more lovely and kind. In fact, a lot of the bad behavior that is observed in people has its origine in the lack of trust in God. They are on the defensive.

    4) When a persons believes in God, believes that there is reward after this life, in the Hereafter, then the persons can accept the idea of not living a life that is not 100% perfect, because anyways this life is a test, the real life is in Paradise.

    My mum is a doctor, not me. She wants me to be a doctor. The problem is that once I start working with them, I am not sure that they will teach me very well, or that they will treat me very well or that I will have the freedome to do the correct thing when they belive that the wrong thing is better. I mean, I like this job, but I want to be a doctor if I can for exemple choose not to administrate vaccins, or drugs that I am not sure of. If I can choose to stop working when I see that I really can’t work at that moment and if I do I will harm the patient. I want things to be right in the medical field before I enter it. It takes a team work to change things, people have to start thinking and questionning things and not just accepting whatever is presented to them.

    Thanks for posting your story Ali, it is good to know what is going on there.


  45. Colleen

    Jesus, it’s been how many years since this was posted? And it’s still getting comments. Seems some things will never cease to be relevant.

    I’m nineteen – admittedly still a kid, yeah – and I just finished my first semester at a university, studying forensic anthropology of all things, simply because I find osteology beautiful. Typical intelligence, honors student, decent GPA, blah blah blah. I thought I would go off to college and things would at least start to fall together. As it turns out, I’m bored as hell.

    When I was small, my parents kept this gargantuan medical dictionary on the coffee table of our living room. I used to fantasize about being a doctor, but I never realized I was smart enough to actually get into medical school – I lived in the combined shadow of my two older sisters, the geniuses. But after a year away from that poisonous atmosphere, I’m beginning to understand that I’m not quite so useless as I once thought. My mother, with her job as a radiology tech, is the only other person in my family who can name even twenty percent of the bones in the body. I’m good with memorization, chemistry, biology… whatever; you get it. I’m smart. Ish.

    Most of my desire to go into medicine, I think, stems from my desire to be intellectually stimulated – but don’t get me wrong; I understand that’s only a partial factor in practicing. I am terrified of growing into full adulthood with this persistent, nagging boredom. I am capable of effective communication, when necessary. I already hate sleeping, eat minimally, and have no expectation of lasting friendships. I do not care about prestige or money, and I like to help people, when at all possible. I have no qualms with death, the smell or the sight or the existential crisis of it (as a student of forensic anthropology, I’m required to have the expectation of dealing with death, anyway).

    Furthermore, while I do not exactly feel that medicine is my one and only possible path to life, or that I am destined to practice it, or even that I need to practice it to realize self-actualization, I think I would find it entertaining, and satisfying, at least in part. What do you think of me, Ali, after the character profile I just built? Do you think I would be a (literally or academically) miserable student?

  46. College freshman

    I would just like to thank everyone for the great comments! They have been the best resource I’ve found yet. I am currently a freshman at a state university on the premed track, but I am beginning to have reservations about going to medical school because it seems that I would be doing it for the wrong reasons (basically, I see becoming a doctor as my “best option” because of the pay, respect, lifestyle, and the fact that you make a positive contribution to humanity). My uncle, who is an orthopedic surgeon, has been reluctant to recommend becoming a doctor, and I now see why. The problem is that I’m not sure what else I would do if I didn’t become a doctor, but I see that this, too, is a bad reason to go to medical school.

    Thanks again for everyone’s input!

  47. Greg

    Ali- I go to one of the more expensive schools because it was the only school I got into. However, most med students are graduating with $200-300K in debt when it’s all said and done. There are no subsidized loans for professional or graduate students, so I am taking the compounding interest into account here.

  48. Greg

    I’m a first year medical student. I wanted to share an honest breakdown of my thoughts so far:

    1) Money: I’m not even done with one year of medical school and I just crossed the $100K mark on my loans (had some from undergrad). By the time I’m done with medical school I’m looking at nearly $400K in student loan debt at an averaged 6% interest. I live very frugally,rent sectional housing (double wide trailer), grow my own fruits and vegetables, and work 15 hours/wk at the school library. Some of my fellow students are taking out way more money than me and they will be nearing the $500K mark, justifying it by the fact they will be “making tons of money” when they are doctors. Sad to see people who have come this far and have no idea what they are getting into. Go onto any student loan site and type in these numbers. See what you come up with. My total loan repayment will be the equivalent of buying a 4 bedroom house, 2 average cars, and an all expenses paid around the world vacation.

    2) Time: I average 12 hour work days. Mind you I’m in my first year of school and I’m working hard to prepare for boards. The good thing is I mostly make my own schedule. If it’s a nice day I’ll take a few hours in the morning and go fly fishing or trail running. Rainy day I’ll take some time at night and play video games or watch a movie. Some days, like today, I will study for around 16 hours straight, sleep for 6 hours, and repeat for the next few days before my test. I probably spend more time studying than most of my class, but I’m a slow learner. I rank in the middle of my class. Most of the people above me work harder, are gifted with photographic memory, or have a post-graduate degree in a medically related subject.

    3) Relationships: I have an amazing girlfriend that I have been dating for the past year. We are very happy together but I will say our relationship would be better if I wasn’t in Med School. She lives 3 hours away and we spend 1-2 weekends a month together. The distance has been difficult but she is very, very, understanding. It also helps that she is as busy as I am during the week with her job. We spend summers and vacations together and skype twice a day. I am not sure what the future holds for us but I am optimistic. She knows that I won’t always be there, that my patients will come first, and sometimes I’ll be exhausted, frustrated, or sad. Sounds cliche but she’s different from most girls and I think we can make it work.
    I haven’t seen my “pre-med friends” in months, but I do my best to stay in touch with them. I have it easy here because I’ve lived all over the country and have experience staying in touch with people and making new friends.
    Most of the people in my class are socially awkward. I have a small group of friends and we study together/ hang out when there’s time.

    4) Happiness: Am I happy? Yes, because I choose to be. It’s easy to surround yourself with people who complain and fall into that trap. I take my life one day at a time. I’m taking aim at my future, remembering my past, but focusing on the present.

    5) Physical well-being: I’m not in terrible shape, but this is the worst shape I’ve been in my whole life. Medical school is very sedentary. I eat very healthy, try to exercise every day, but the effects of sitting down 10-12 hours a day take their toll. I’ve had a host of illnesses in the past year that are likely a result of stress and lack of sleep. I would say this is the number 1 problem I have with med school. I need to find better ways to release stress because I know it only gets worse.

    6) Outlook: I really am worried about what’s going to happen to America’s healthcare system. I think as a whole we are going in the wrong direction. However, I am very optimistic for my career as an individual because:

    a) I know the career I’ve chosen is not for the weary. I took several years off between undergrad and med school. I knew what I was getting into before I started. I know most doctors don’t recommend it or wouldn’t do it again. I don’t care. I’m doing it because I can’t see myself doing anything else and I love it.

    b) I absolutely do not expect to “get rich” from medicine AT ALL. I have a very realistic, some would even say pessimistic view on compensation. ANYONE WHO EXPECTS TO GET RICH AS A DOCTOR IS SEVERELY MISGUIDED AND SHOULD NOT GO INTO MEDICINE!!! YOU WILL BE MISERABLE!!! The fact is, doctor’s salaries are going down and will continue to do so until the system breaks. I feel bad for physicians who rely on their practices as their sole means of income. I have a history as an entrepreneur: I’ve started and sold businesses in the past. I’m going into medicine with an entrepreneurial mindset and knowing that I will have to rely on a side-hustle to live a comfortable life.

    c) I love medicine, I love people, and I love learning.

    MY ADVICE: Take a year or two off before going to medical school. Know what you’re getting into. Understand how much money $500k is and how loans work. Please note that medicine is not an “easy way to make a few hundred thousand a year.” Shadow as many doctors as you can and ask questions about their happiness, income, etc. (be respectful though). Understand our country’s current state. LEARN about the affordable care act!

    And no matter what, KNOW THAT IT’S OK TO SAY NO TO MEDICAL SCHOOL. It’s not for everyone! YOU CAN LIVE A LIFE OF SERVICE, IMPORTANCE, AND WEALTH WITHOUT BEING A DOCTOR! But to those of you who choose medicine: welcome, and good luck.

    • Greg – thanks for the contribution and your generosity with your thoughts. It’s always useful to hear from people who are actually having the experience. Didn’t know med school got so expensive so fast, but it makes sense. -AB

  49. Wanderer

    The longer one’s writings lasts on the limelights, the bigger is it’s value. I have read many comments, here is my contribution.
    Congratulations for this honest blog. Until I went to these internet blogs, feeling unfit for healthcare was something I had to suppress constantly, for fear of loosing my job or even my registry. It’s a terror. One disadvantage of being a doctor as I am (NOT FOR THE SINGLE GOOD REASON!) is the absolute lack of options outside practice. It’s hard to be on “NPC” pathways, on must be a brilliant doll with a shinning CV to be called for these opportunities. Otherwise, nothing happens. I keep trying but for a while I am grateful just for having some way of win my life with dignity. That dignity of an educated white coated steward, but that’s ok. Today I am not working as before, I am sorry to say that I don’t think I will be anything more respectable than what I am now, and that is a very bad feeling. I gathered savings and stopped working. That is even worst, since now I have no occupation at all. I am just sad because I did worked and had to stand many things to be here, eat grass and all that energy could have been directed to something I liked more, allowing me the chance of being something relevant and admirable. So many people did write their thought here, I think I have the right, isnt it? Please, don’t send the cops after me ok? Hey I got so angry about my profession that now my favorite sport is throw tomatoes over myself. lol. What a shame.

  50. Jay

    I’m a 58-year-old cardiologist, and I must say this is both a well-written, spoken, and researched article. In numerous lectures I’ve given to both high school and college students regarding their future career choices my #1 take-home message is: Know the down sides of your considerations! Know that there are no perfect options/jobs/careers. This blog provides an excellent starting point for those with serious medical aspirations, and I believe should be taken seriously. As a suggestion, links to other/related career choices might be added in future editions for when one realizes that doctors are leaving medicine in droves for many reasons……………..

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